Provider Demographics
NPI:1649581760
Name:WESCOTT, JEANNE R (LCSW-R)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:R
Last Name:WESCOTT
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 MAIN STREET
Mailing Address - Street 2:WINDSOR CENTRAL SCHOOL DISTRICT
Mailing Address - City:WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:13865-4134
Mailing Address - Country:US
Mailing Address - Phone:607-655-6259
Mailing Address - Fax:607-655-8301
Practice Address - Street 1:213 MAIN ST
Practice Address - Street 2:ALICE FREEMAN PALMER ELEMENTARY
Practice Address - City:WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:13865-4134
Practice Address - Country:US
Practice Address - Phone:607-655-1998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0353861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical